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Blears E, Kuo SCE, Tiongco RFP, Suresh R, Cooney CM, Caffrey J. Associations of urban versus rural patient residence on outcomes after burn: A national inpatient sample database study. Burns 2024; 50:1463-1474. [PMID: 38584006 DOI: 10.1016/j.burns.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/06/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION Burn patients in rural areas may encounter poorer outcomes associated with barriers to care; however, residence has not been studied in a large sample. The association between rural-versus-urban residence and outcomes after burn was examined using the National Inpatient Sample (NIS) database. METHODS Using the 2019 NIS database, patients over 18 years with a primary diagnosis of burn or corrosive injury were included. Level of urbanization was categorized into six groups. Outcomes after burn such as in-hospital mortality, multifactorial shock, prolonged mechanical ventilation, length of stay, and total costs were analyzed after adjusting for demographic factors and hospital characteristics. RESULTS We included 4671 records, which represented a weighted population of 23,085 patients. Rural residence was associated with higher percentage of prior transfer but not in-hospital mortality. Compared to the most urbanized counties, encounters from the most rural counties were associated with higher odds of shock (aOR:2.62, 99% CI: 1.04-6.56, p = 0.007). CONCLUSION Burn encounters from less urbanized counties did not experience differences in mortality, rates of skin grafting, prolonged mechanical ventilation, length of stay, or overall costs. However, odds of shock were higher among the least urbanized counties. Despite improved triage and transportation systems across the US, disparities and challenges exist for burn patients from rural residence.
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Affiliation(s)
- Elizabeth Blears
- Bayview Burn Center, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Shih-Chiang Edward Kuo
- Bayview Burn Center, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Rafael Felix P Tiongco
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rachana Suresh
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Carisa M Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Julie Caffrey
- Bayview Burn Center, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Zia N, Mashreky SR, He H, Patel N, Ahmed FA, Hashmi M, Al-Ibran E, Rahman AF, Khondoker S, Hyder AA, Latif A. Factors associated with emergency department disposition among burn injury patients: Analysis of prehospital and emergency care characteristics using South Asia Burn Registry (SABR) data. Burns 2024; 50:874-884. [PMID: 38245393 PMCID: PMC11055681 DOI: 10.1016/j.burns.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 12/17/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Improvement in burn injury data collections and the quality of databanks has allowed meaningful study of the epidemiologic trends in burn care. The study assessed factors associated with disposition of burn injury patients from emergency department accounting for pre-hospital care and emergency care. METHODS This prospective observational pilot study of the South Asia Burn Registry project was conducted at selected public sector burn centers in Bangladesh and Pakistan (September 2014 - January 2015). All age groups with an initial presentation to the burn centers were enrolled. Descriptive and regression analysis is presented. RESULTS A total of 2749 patients were enrolled. The mean age was 21.7 ± 18.0 years, 55.3% were males, and about a quarter were children < 5 years. About 46.9% of the females were housewives. Scald burns were common among children (67.6%) while flame burns were common among adults (44.3%). About 75% of patients were brought in via non-ambulance mode of transport. More than 55% of patients were referrals from other facilities or clinics. The most common first aid given pre-hospital was the use of water or oil. About 25% were admitted for further care. The adjusted odds of being admitted compared to being sent home were highest for children < 5 yrs, those with higher total body surface area burnt, having arrived via ambulance, scald and electrical burn, having an associated injury and inhalational injury. CONCLUSION The study provides insight into emergency burn care and associated factors that influenced outcomes for patients with burn injuries.
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Affiliation(s)
- Nukhba Zia
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Huan He
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nishit Patel
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fasih Ali Ahmed
- Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University Hospital, Karachi, Pakistan
| | | | | | - Sazzad Khondoker
- National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
| | - Adnan A Hyder
- Center on Commercial Determinants of Health and Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Asad Latif
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Anesthesiology, Aga Khan University, Karachi, Pakistan
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Puvanachandra P, Ssesumugabo C, Balugaba BE, Ivers R, Kobusingye O, Peden M. The epidemiology and characteristics of injuries to under 5's in a secondary city in Uganda: a retrospective review of hospital data. Int J Inj Contr Saf Promot 2022; 29:550-555. [PMID: 35797975 DOI: 10.1080/17457300.2022.2089686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Child injuries are largely preventable yet cause significant mortality and morbidity globally. Injury data from low-income countries is limited for children under the age of 5 and therefore the current understanding of the magnitude of injuries in this age group is low. Hospital-based registries are one mechanism by which injury data can be gathered. This paper presents findings from a retrospective hospital record review of 4 hospitals in Jinja, a rural setting in Uganda, involving the extraction of data for children under the age of 5-years who sustained an injury during a 6-month period in 2019. A total of 225 injury cases were retrieved from the hospitals. Over half (57.3%) of the events occurred among males. The majority (92%) suffered one injury per injury event. Most of the injuries occurred among those aged 13 to 24 months (32.9%). Burns (32%) and cuts (20%) were the most common cause of injury. This study presents a hospital-based analysis of injuries amongst under 5's in rural Uganda. It provides information on the characteristics of children entering healthcare facilities in Uganda and highlights the burden of paediatric injuries in the hospital setting.
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Affiliation(s)
- P Puvanachandra
- The George Institute for Global Health, UK, Imperial College London, London, UK
| | - C Ssesumugabo
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - B E Balugaba
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - R Ivers
- School of Population Health, University of New South Wales, Sydney, Australia
| | - O Kobusingye
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - M Peden
- The George Institute for Global Health, UK, Imperial College London, London, UK
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Hosseinpour H, Kamran H, Zahmatkesh Meimandi F, Shahrbaf MA, Shekouhi R, Salimi M, Marzban MR, Sohooli M, Hoghoughi MA. A retrospective epidemiological study of outpatient burn care during 2010–2019 in Iran. BURNS OPEN 2022. [DOI: 10.1016/j.burnso.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gurbuz K, Demir M, Das K. A survey of YouTube videos as a source of useful/un-useful information in the field of the prevention and management of burn injuries: A cross-sectional analysis of the English language content. J Burn Care Res 2021; 43:971-976. [PMID: 34877599 DOI: 10.1093/jbcr/irab231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study was designed on whether YouTube videos are useful as an information resource in the field of burn injury prevention and management. Current literature on the educational content and quality of burn-related first aid videos on YouTube was reported as inadequate and inaccurate. However, the quality of YouTube videos on various medical and clinical topics has been the subject of many previous studies, and there has been increasing evidence that the content ratio of usefulness was higher than that of non-useful. While hours and even minutes in burn injuries are as precious as gold in terms of outcomes, it would be a significant loss not to use the most popular and easily accessible free social media platform of our time as a tool that can contribute to the prevention of burns and raise awareness. Analysis was conducted with the remaining 96 videos from 240 videos obtained from YouTube, according to possible search terms and exclusion of videos according to predetermined criteria. The Global Quality Score (GQS) and modified DISCERN (m.DISCERN) tools were used to assess the quality and reliability of the videos. Viewer engagement metrics and video properties were also investigated according to the usefulness criteria (e.g., video length, duration on YouTube, topic contents, source uploads, reliability, and quality). Finally, it was revealed that nearly 80 percent of the YouTube videos contained information in the field of the prevention and management of burn injuries deemed useful in this study, comparable to the other medical disciplines' reports in the literature.
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Affiliation(s)
- Kayhan Gurbuz
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkey
| | - Mete Demir
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkey
| | - Koray Das
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkey
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Abu Ibaid AH, Hebron CA, Qaysse HA, Coyne MJ, Potokar TS, Shalltoot FA, Shalabi MA. Epidemiology, aetiology and knowledge, attitudes, and practices relating to burn injuries in Palestine: A community-level research. Int Wound J 2021; 19:1210-1220. [PMID: 34761542 PMCID: PMC9284619 DOI: 10.1111/iwj.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022] Open
Abstract
The aim of this study was to identify the epidemiology, aetiology as well as the knowledge, attitudes, and practices relating to burn injuries in Palestine. A mixed‐method approach was used. A survey was distributed to a total of 1500 households selected by randomised approach. The survey was standardised based on World Health Organisation's guidelines for conducting community surveys on injury. Additionally, there were 12 focus group discussions and 10 key informant interviews to collect rich qualitative data. In the West Bank and Gaza, 1.5% of Palestinians had experienced serious burn injuries in the 12 months. The total sample of 1500 yields a margin of error (plus/minus) = 2.5% at a 95% level of confidence and a response distribution (P = 50%) with 3% non‐response rate. Of the 1500 households approached, 184 reported a total of 196 burn injuries, with 87.2% occurring inside the home: 69.4% were females and 39.3% were children. The main source of reported cause of burn was heat and flame (36%), electric current (31.6%), hot liquid (28.6%), and chemicals (2.7%). The most common first aid for burns was pouring water (74.7%). People in rural, refugee, and Bedouin settings had the highest incidence of burns. This study provides the burn prevalence rate, explanatory factors that contribute to the frequency of burns in Palestine. Making burn prevention a higher priority within the national policy is crucial.
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Affiliation(s)
| | - Caitlin A Hebron
- Centre for Global Burn, Policy & Research, Swansea University, Swansea, UK.,NIHR Global Health Research Group on Burn Trauma, Swansea, UK.,International Network for Training, Education & Research in Burns "Interburns", Cardiff, UK
| | | | | | - Tom S Potokar
- Centre for Global Burn, Policy & Research, Swansea University, Swansea, UK.,NIHR Global Health Research Group on Burn Trauma, Swansea, UK.,International Network for Training, Education & Research in Burns "Interburns", Cardiff, UK
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Eylert G, Reilly D, Placek J, Kozmann V, Khan R, Neuhann-Lorenz C. Challenges and opportunities in plastic reconstructive surgery and burn care in Bangladesh. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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